Table 1.
The 2016 revised ACR criteria for the diagnosis of GCA
| |
Score | Entry |
N/A | Age at onset 50 years |
Absence of exclusion criteria | |
Domain I | |
1 | New-onset localized headache, 1 point (p) |
1 | Sudden onset of visual disturbance, 1 point |
2 | Polymyalgia rheumatica, 2 points |
1 | Jaw claudication, 1 point |
2 | Abnormal temporal artery, up to 2 points |
Domain II | |
1 | Unexplained fever and/or anemia, 1 point |
1 | ESR 50 mm/hour, 1 point |
2 | Compatible pathology, up to 2 points |
ACR, American College of Rheumatology; ESR, erythrocyte sedimentation rate; GCA, giant cell arteritis; N/A, not applicable In the presence of three points or more out of the eleven with at least one point belonging to domain I along with all entry criteria, a diagnosis of GCA can be established. The exclusion criteria included ear, nose, and throat or/and eye inflammation; kidney, skin, or peripheral nervous system involvement; lung infiltration; lymphadenopathies; stiff neck; and digital gangrene or ulceration. No other etiologies can better explain any one of the criteria. Enlarged and/or pulseless temporal artery (one point)/tender temporal artery (one point). It must be ignored in the presence of polymyalgia rheumatica. Vascular and/or perivascular fibrinoid necrosis along with leucocyte infiltration (one point) and granuloma (one point). |